Denial Reason Code C029 – Timely Filing Limit Exceeded
Denial Reason Code C029 -
Timely Filing let us understand the denial reason most of the insurance will set
a specific timely filing limit to submit a claim. If claim is filed after
timely filing limit it will be denied stating timely filing limit has been
expired.
If claims timely filing limit is 180 days from date of
service then claims must be submitted within that timely filing limit.
Timely filing limit varies from insurance to insurance, and it also
depends on a provider contract.
[ For Example ] As we know medicare claims timely
filing limit is one year from date of service we will take the example of a
medicare payer here our date of service is a january 1st of 2020 and claims
timely filing ends on december 31st of 2020. claim was initially filed to
medicare on january 1st of 2021 and it was received by payer on january 2nd of
2021 that is after one year from date of service so here medicare will
obviously deny this claim stating crosstalk timely filing limit.
So how to follow up on these claims so first thing we need
to check what is the time filing limit to submit the claim, and we need to
verify what is the claim received date. If claim was submitted after the timely
filing limit we need to check if we have any proof of timely filing. So what is
proof of timely filing it's a document or evidence that supports the reason why
this claim was submitted after the time filing limit.
[ For example ] If patient has two insurance policies active
on date of service april 1st of 2020 primary insurance claim timely filing
limit is 60 days from date of service that is till may 30 of 2020. We see that
claim was filed to secondary insurance on may 15 of 2020 in error so however
secondary insurance received the claim on may 20 of 2020 and it was denied
stating other insurances primary on may 28th of 2020. so later someone verified
and claim filed to primary insurance on june 2nd of 2020 which was denied as a
claim filed after timely filing limit here we have a secondary insurance denial
EOB as a proof of timely filing in this case we need to submit an appeal with
the proof of timely filing to primary insurance studying claim was initially
submitted to secondary insurance in error we have attached the proof of timely
filing kindly review and reprocess the claim accordingly
If proof of timely filing is valid insurance will reprocess
the claim if there is no proof of timely filing provider need to adjust the
claim sometimes if build amount is higher than as per provider request we may need
to send an courtesy appeal to payer requesting to reconsider the claim as this
claim has a higher dollar value here is the notes if we have a proof of timely
filing please go through it do.
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